Mental Health

Improving the care of children and young people who self-harm

Within Europe, the UK has one of the highest rates of self-harm, which is particularly prevalent in children and young people (CYPs).

Self-harm accounts for a high proportion of acute hospital admissions. However, nurses without specific training have been identified as ill-equipped to adequately care for CYPs who self-harm. Misconceptions and anxieties may explain negative attitudes towards those who self-harm. This negatively impacts upon the quality, experience and care received by CYPs and their families. This study aimed to address these deficits by developing an educational program co-produced with CYPs, aimed at nurses who care for hospitalized CYPs that self-harm.  

'Our care through our eyes' is a service user co-produced education programme for acute hospital nurses to improve the care of children and young people that self-harm funded by the Burdett Trust for Nursing (Chief Investigator - Dr Joseph Manning). The study was delivered in partnership with:

  • Nottingham Children’s Hospital
  • Nottingham University Hospitals
  • NHS Trust  

The MRC Complex Intervention Framework (2000) guided the project development and evaluation (Phase I and II). A three stage collaborative design was applied: 

Stage 1

A stakeholder engagement priority-setting activity with CYPs who have been hospitalised with self-harm, carers, nurses, and topic experts using a 2-phase Delphi technique. The Delphi method obtains reliable consensus of opinion from a group of experts through a series of questions interspersed with controlled opinion feedback (Rowe & Wright, 1999). This established information needs and educational topic priorities.  

Stage 2

The development of a co-produced educational intervention based on priorities identified in stage 1. Children, young people and registered children’s nurses participated in focus groups and Reusable Learning Objects (RLO) design workshops. RLOs are multimedia learning tools effective in communicating information, developed using collaborative design processes. Ideas were generated and refined for storyboards, using established RLO design methodology. Three RLOs were developed.  

Stage 3

The third stage involved implementation and evaluation (pre and post-test) of the educational intervention with registered nurses and CYPs at NCH.


The study has resulted in the development of a high quality, relevant and accessible online educational programme the will be launched nationally by the Burdett Trust in Autumn 2016 with the aim of improving the knowledge, confidence and attitudes of registered children’s nursing caring for CYP with self-harm. 


Mental Health Research Group

The University of Nottingham
School of Health Sciences
Queen's Medical Centre
Nottingham, NG7 2HA

telephone: +44 (0)115 823 0812